Have been battling hypo for a while now. Started on T4 did not feel any better, went to NDT (private doc) felt worse and it cost a lot of money. Now back to the good old NHS and was prescribed 25 mcg levo and 10 mcg T3 by an endo. Been on this dose for the last 3 months.

Still feel so awful, so tired and legs tingling and aching.

My results are as follows

TSH 4.29 (0.35-5)

T4 7.2 (7-20)

No T3 done although requested. as they deemed my T4 to be satisfactory.

My GP said these results were fine.

Would appreciate any input as I get a bit confused when T3 is in the mix as to what the results should start to look like.

Am seeing the endo in 3 days so would like to know what to ask him. Really do not feel well at all.

13 Replies

Well of course they are not fine, you still feel ill. The free t4 is really low, and 25 mcg is a teeny dose..... The amount of t3 you are taking isnT anywhere near enough to even suppress the tsh..... Te guidelines in the British national formulary for Liothyronine, say start with 20. Or 10 if there are problems with heart or old age. And work up in split doses up to a max of 60.... Suggest you log in to the bnf. ( its free) and print off the dosage instructions.

Personally if I was you I would try a different dose to see if it made a difference, but if you don't understand how it works, or don't feel confident, your best bet is to try and convince your doctor to increase your meds. The dr toft book, understanding thyroid, which was written by an Nhs endo, may be enough to convince your doc. The book is available from chemists and eBay for less than £5.

Your TSH is too high. Unfortunately, many doctors are none the wiser on how to treat patients with thyroid gland problems. It is a 'hit or miss' for patients to land with a doctor who is informed about the dysfunction of the thyroid gland and how we are affected if not on an optimum dose.

Galathea is right and has made good suggestions. When you get your next blood test, do NOT take medication beforehand and get it as early as possible.

Many GP's refused to add T3 since it is more costly and I'm not sure why it was added if NDT (contains natural T3) made you feel worse. Are you sure you gave it a good trial?

It does take time for synthetic T4 to leave your system (weeks) and natural desiccated hormone to take affect.

Your T4 is going to be on the low side since you are only taking 25 mcg. and may not matter if your FT3 is high. Of course, no one knows what that is. Express to your GP that without the FT3 test and since you feel unwell, it is probably also very low. Insist that you raise something since your TSH is still in the higher part of the range. Three months is long enough to see the results of that dose so don't be put off. An increase of either T4 or T3 could be tried.

The first link will give you an idea. Your T4 should probably be around 15 in order for you to convert enough to FT3 to aleve your symptoms. But taking 25 mcg will never get you there in my opinion. On the other hand, if you are taking enough T3 to relieve your symptoms, you don't need to have FT4 any higher than it is right now.

You could read the other links on that page I just posted since you are adding T3 separately.

Without all the tests taken at the same time (FT4, FT3, TSH) (and even reverse T3), it really is pretty impossible to answer your question.

I was on T3 20 and 75 eltroxin for four weeks and felt the very same my doc took me off the meds 4 days ago and I'm back on eltroxin the only improvement was the tingling and aching went I still feel awfully tired back on 100/75 eltroxin alternate days my appetite crashed and I lost a lot of weight on the combo t3/t4 still can't seem to get rid of the awful exaustion I didn't have that until I went on the combo it's like my body just crashed.

When will the doctors and the labs realised that a FT3 result is important. My GP doesn't feel confident in dealing with me now Dr Skinner has sadly died but agreed to me seeing someone else. She sensibly thought that before referring me she would do loads of bloods as that would then speed things up. Recently the lab had done FT3 as TSH is suppressed. I think my previous results suggest I may not be converting. Results came back. Folate still very low but everything else done ok except thyroid ones. For whatever reason TSH now has a reading though still well below range, FT4 gone down, was top of range and a snotty message from labs that FT3 wasn't done as FT4 high and TSH low so I must be over medicated! The results arrived the week I was struggling to keep awake in the day and was feeling pretty rough! My GP did ring me to apologise, I'd rather she had rung the lab to complain! I was feeling so comatose I could only thank her for the call, just couldn't think or react quickly enough! Have gone out though and got some Folic Acid whilst waiting for the Lamberts B Complex to arrive. Referral appointment 10 June. By then I shall have made my list!

It makes my blood boil that the labs are taking it upon themselves to decide when it is relevant to test T3. I am surprised the consultants are putting up with it. Now I am on T3 I would have thought they would need to know what my level is. Not according to the lab. The endo had written on the form that he wanted T3 testing but no they decided not to. Crazy!!